ShareExpress2000 program license number re-issuing request.

This form is only to be used by registered ShareExpress2000 users (users who paid 
the initial program registration fee). If you are not a registered user please visit this page.

A license re-issuing fee of AU$12.95 is applicable. Re-issuing a license number is a 
manual process and requires the re-configuring of our quotes server to accept your new 
account details. We appreciate your understanding.

Please complete this form to request a new license number (all fields are mandatory).

 First name : *  
 Surname : *  
 Phone number : *
[Please include area  code]
 Address : *  
 Post code : *  
 State : *  
 Country : *  
 Current program serial
 number :
[We will not be able to process 
 your request without this number]
 To find this number run ShareExpress and then press the
 'About' button located on the program main screen. This 
 number looks something like that 
 Email address : *
[Must be valid. The new license 
 number will be sent to this address]
 Pay by credit card : *
[Select card type and fill out card

  for payment by cheque or money
  order please read below.

Visa    MasterCard   Amex    
[Sorry, other cards unavailable]

Name on card :  
Card Number :   - - -
Expiry date :  
To be charged :   AU$12.95
Signature :   _______________________



For registration via post/fax
If you would prefer to register by post/fax (cheque, money order). Please print and complete 
the above request form.

Our postal address is : Pty Ltd, 1/17 William St. Rose Bay 2029 NSW Australia
Our fax number : 02-93713054
(if dialing within Australia)  61-2-93713054 (if outside Australia)

Please make cheque/money_order payable to: Pty Ltd